Development of a Measure of Discrimination within the Health Care System: Preliminary Findings of Pre-Colonoscopy Patient Surveys

Colorectal screenings, used to detect and remove pre-cancerous polyps are usually recommended every 10 years.4 Overall, 58.6% of adults are up-to-date with their colorectal screening, compared to the Healthy People 2020 target of 70.5%. Rates of colorectal screening are lower than they should be; one potential barrier is perceived discrimination resulting in lack of trust of doctors and the health care system. 290 patients and caregivers completed a paper-based survey, which included their perception of treatment discrepancies and medical trust. Participants reported their level of agreement with 12 statements such as, “doctors treat poor people worse than rich people” (perceived discrimination) and “I trust what the doctors tell me” (Health Care System trust). Patients were female (62%), White (78.6%), middle- aged (mean = 52 YO), employed full time (53%). Results of the factor analysis (using SPSS-20) revealed that two underlying constructs explained 66% of the variance, and a KMO of .89 indicated strong evidence of underlying constructs. Factor 1 (6 items) reflected treatment of at risk groups; Cronbach's alpha = .88 and the mean inter-item correlation (MIC) = .55. Factor 2 (4 items) reflected personal trust in doctors and the health care system with a Cronbach's alpha of .83 and MIC of .55. The two scales showed strong factor structure and excellent inter-item correlation. They will be used in further analysis to see if the same psychometric properties hold in responses from caregivers. Ongoing data collection will explore differences based on socio-demographic characteristics and compliance with follow-up colorectal screening recommendations.